儿童部分腓骨切除后对供侧肢体的影响

目的：探讨部分腓骨切除后对儿童供侧肢体功能及形态的影响。方法：对3－12岁患原发性排骨近端骨巨细胞瘤、胫骨骨折骨缺损及股骨头坏死的儿童共63例，经小腿前外侧入路行部分带血管腓骨切取术，术后随访3－10年，用踝关节功能测定仪、运动负荷试验，胫腓骨及踝关节X线片测量及评价双侧肢体功能及形态。结果：无一例肢体发育障碍或发生坏死。腓深神经或腓浅神经损伤占11％，但多数在术后3月内自行恢复，仅2例留有持久腓浅神经损伤表现，做运动负荷试验后检查30例病人中2例轻度踝疼，1例有较明显的踝疼。随患儿身高的增加，供骨侧腓骨远近两残端逐渐增长，但缺损间隙不变。结论：儿童部分腓骨被切除以后，多数供侧肢体无严重并发症，30例中有3例踝部疼痛者与腓骨切除较长有关。远期腓骨缺损间隙相对变短，这有利于儿童晚期供侧踝关节的稳定性。

Influence to the donor limb foll owing partial excision of fibula in chil dren

Objective To study the influence of function and appearance of the donor limb after excising a part of fibula in children.Methods A part of fibula partly with blood vessels were excised from anterolateral leg in 63 children of 3～12 years old,who suffered from giant cell tumor of bone of fibula,bone defects and femoral head necrosis.The cases were followed up for 3～10 years for the study of ankle function following partial resection of the fibula.The function and appearance of both low limbs were examined and evaluated by using determination instrument of ankle function,sport loading test and X-ray film of tibia and fibula and ankle joints.Results There were no developmental disturbance and necrosis of limbs occurred in all cases followed.The injury rate of profound peroneal nerve or superficial peroneal nerve in operation was 11 percent,but many cases could spontaneously recover in three months after operation.Only two cases remained continuous injury of superficial peroneal nerve.Of 30 cases done sport loading test,2 patients had slight ankle pain and 1 had obvious ankle pain.With growing,the remained two parts of the fibula in donor limb could become longer,but the length of the empty part between them did not change.Conclusion No serious complication occurred in donor limbs of most children after excising a part of fibula.The ankle pain in 3 cases was related to the excised length of fibula.The vacancy length left in the fibula become shorter relatively long-term after operation in children,which is benefit to the stability of ankle joint of donor side in future.